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The nurse is reviewing new orders for a client with chronic kidney disease. The nurse should clarify the order for
- A. dietary sodium restriction
- B. magnesium hydroxide
- C. fluid restriction
- D. furosemide
Correct Answer: B
Rationale: Magnesium hydroxide risks toxicity in CKD due to impaired excretion. Sodium restriction , fluid restriction , and furosemide are appropriate.
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The home health nurse is reviewing current medications with a client who has hypertension. Which of the following statements by the client would require follow-up?
- A. I take omeprazole daily to prevent heartburn.
- B. I regularly take ibuprofen for chronic low back pain.
- C. I occasionally take docusate sodium for constipation.
- D. I take hydrochlorothiazide daily to lower my blood pressure.
Correct Answer: B
Rationale: Ibuprofen can reduce the efficacy of antihypertensives and cause fluid retention, worsening hypertension. Omeprazole , docusate , and hydrochlorothiazide are unlikely to interfere with hypertension management.
The nurse is caring for a client who does not speak English. Which of the following actions should the nurse take to facilitate communication with the client? Select all that apply.
- A. Allow the client's spouse to act as the interpreter.
- B. Use short sentences when speaking to the interpreter.
- C. Ask if the client has a gender preference for the interpreter.
- D. Speak directly to the interpreter when providing information.
- E. Ensure the client understands the information provided via the interpreter.
Correct Answer: B,C,E
Rationale: Short sentences aid clarity. Gender preference respects cultural needs. Ensuring understanding confirms effective communication. Using a spouse risks bias, and speaking to the interpreter excludes the client.
The nurse is providing home care to a man who had a transsphenoidal hypophysectomy the day before yesterday. Which behavior by the client indicates a need for more teaching?
- A. He bends over to tie his shoes.
- B. He tells the nurse he takes a lot of pills every day.
- C. He ambulates daily.
- D. He tells the nurse he has ordered a medical identification bracelet.
Correct Answer: A
Rationale: Bending over increases intracranial pressure, risking cerebrospinal fluid leak post-hypophysectomy, indicating a need for further teaching on activity restrictions.
The practical nurse is collaborating with the registered nurse to develop a care plan for a homeless client just brought into the emergency department with frostbite to the fingers and toes. The client is experiencing numbness, and assessment shows mottled skin. Which interventions should be included in the client's plan of care? Select all that apply.
- A. Apply occlusive dressings after rewarming
- B. Elevate affected extremities after rewarming
- C. Massage the areas to increase circulation
- D. Provide adequate analgesia
- E. Provide continuous warm water soaks
Correct Answer: B,D
Rationale: Elevation reduces swelling post-rewarming. Analgesia manages pain. Occlusive dressings trap moisture, massaging risks tissue damage, and continuous soaks may cause maceration.
A 7 year-old child is hospitalized following a major burn to the lower extremities. A diet high in protein and carbohydrates is recommended. The nurse informs the child and family that the most important reason for this diet is to
- A. Promote healing and strengthen the immune system
- B. Provide a well balanced nutritional intake
- C. Stimulate increased peristalsis absorption
- D. Spare protein catabolism to meet metabolic needs
Correct Answer: D
Rationale: Spare protein catabolism to meet metabolic needs. A high-carbohydrate diet prevents protein breakdown for energy, allowing proteins to restore tissue.